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Taboos around menopause, periods can limit access to care in women’s health: new report

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Taboos around menopause, periods and conditions like endometriosis can limit access to knowledge and care, says a report by the Alberta Women’s Health Foundation.

The report, “Surveying the Silence: Exploring the Taboos in Women’s Health,” canvassed more than 2,200 Albertans who identify as women to understand their top health issues, concerns and experiences.

“Taboos are social customs restricting discussion on specific topics,” Sharlene Rutherford, president and CEO of the foundation, said at a news conference Wednesday. “They create a culture of silence, it limits access to knowledge and care, and taboos can harm an individual’s health, an individual’s mental health and their well-being.

“Taboos perpetuate discrimination, they perpetuate negative stereotypes, they can be isolating and they can contribute to inequities.”

The survey respondents each reported an average of five pelvic health issues, including painful periods, pelvic floor dysfunction, fibroids and regular yeast infections.

About two-thirds found it difficult to talk to their primary health-care providers about their concerns and only a quarter felt “very knowledgeable” about their gynecological and reproductive health.

The survey also found delays in treatment were common, with 85 per cent of women who had a more complicated diagnosis, such as endometriosis, reporting a wait for care.

‘Disturbing lack of knowledge’

Kristina Jarvis, 40, said she was diagnosed with polycystic ovary syndrome — a condition in which a woman has increased levels of male hormones — at the age of 29.

“The first symptom … was actually hair loss around the age of 14 or 15,” she said. “My mom suggested it was probably due to stress.”

Jarvis said she then started having irregular periods and a doctor also suggested it could be stress.

She had hormone tests in her late 20s that led to the diagnosis, but she was told she didn’t need to worry about treatment until she wanted to get pregnant.

“I took the doctor at face value,” said Jarvis.

It wasn’t until she was 33 or 34 that she learned there could be other side-effects, including high blood pressure, insulin resistance and a higher chance of cancer.

“There is a disturbing lack of knowledge and care from many, but not all (general practitioners) and doctors,” she said.

“Doctors are definitely the experts, but we also need to be able to push back a bit when we think there is something to be looked at. We also need doctors to be able to hear our stories.”

A patient going through perimenopause told the survey it adds “worry and stress because you don’t know what to expect and if strange new symptoms are indicative of something serious.”

Another woman, who experiences painful periods, said people often think she’s being dramatic when she needs to stay in bed.

Critical insight

Dr. Jane Schulz, chair of the department of obstetrics and gynecology at the University of Alberta’s faculty of medicine, said the survey responses resonated with her.

“It certainly is a taboo topic,” said Schulz, also a urogynecologist at the Lois Hole Hospital for Women in Edmonton. “I am really excited with the release of this publication in terms of breaking barriers and stigma of women’s health.”

Keeping women’s health issues taboo, said the report, plays a role in the disparity of care and lack of research on the topics.

“This report provides critical insight,” said Dr. Sandra Davidge, executive director of the Women and Children’s Health Research Institute.

“Research with a specific focus on women’s health has been neglected far too long. Right now, less than 10 per cent of federal funding from Canadian health research funding is dedicated to women’s health.”

Davidge said, however, that funding from the Alberta Women’s Health Foundation has led to important research for women.

As an example, she said menopause affects 50 per cent of the population — women — but noted there’s a gap in both care and research in the area.

Some researchers, she said, are working to overcome the stigma associated with menopause by supporting women who have severe symptoms.

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Some Ontario docs now offering RSV shot to infants with Quebec rollout set for Nov.

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Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.

The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.

Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.

Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.

Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.

The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.

This report by The Canadian Press was first published Oct. 21, 2024.

-With files from Nicole Ireland

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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Polio is rising in Pakistan ahead of a new vaccination campaign

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ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.

Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.

The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.

Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.

Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.

The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.

Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.

The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.

Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.

The Canadian Press. All rights reserved.

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White House says health insurance needs to fully cover condoms, other over-the-counter birth control

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WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.

Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.

The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.

“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”

The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”

Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.

If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.

Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.

The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.

The Canadian Press. All rights reserved.

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